Challenges associated with the pathological diagnosis of colorectal tumors less than 10 mm in size

Dig Endosc. 2018 Apr:30 Suppl 1:41-44. doi: 10.1111/den.13038.

Abstract

Various techniques including cold snare polypectomy and endoscopic mucosal resection are used for the removal of small colorectal polyps. Specimens of resected polyps are prepared in pathology laboratories and analyzed to make a pathological diagnosis. However, reports on how different resection methods influence the pathological diagnosis are limited. This article discusses the problems associated with the failure of polyp retrieval and fragmentation of small specimens during collection and the effects of certain parameters on the pathological diagnosis, particularly with regard to surgical margins. In the future, although pathologists are expected to encounter problems as a result of minor findings that are not clinically problematic, relatively rare cases such as submucosal invasion by a small carcinoma should not be overlooked.

Keywords: cold snare polypectomy; colon and rectum; endoscopic mucosal resection; pathology; small polyp.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Colonic Polyps / pathology*
  • Colonic Polyps / surgery
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery
  • Endoscopic Mucosal Resection / methods*
  • Female
  • Humans
  • Male
  • Margins of Excision*
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prognosis
  • Risk Assessment
  • Treatment Outcome